Abstract:
Background: The mental health impacts of climate change-related disasters are significant. However, access to mental health services is often limited by the availability of trained clinicians. Although building local community capability for the mental health response is often prioritised in policy settings, the lack of evidence-based programs is problematic. The aim of this study was to test the efficacy of the Skills for Life Adjustment and Resilience programme (SOLAR) delivered by trained local community members following compound disasters (drought, wildfires, pandemic-related lockdowns) in Australia.Method: Thirty-six community members were trained to deliver the SOLAR programme, a skills-based, trauma informed, psychosocial programme. Sixty-six people with anxiety, depression and/or posttraumatic stress symptoms, and impairment were randomised into the SOLAR programme or a Self-Help condition. They were assessed pre, post and two months following the interventions. The SOLAR programme was delivered across five 1-hourly sessions (either face to face or virtually). Those in the Self-Help condition received weekly emails with self-help information including links to online educational videos.Results: Multigroup analyses indicated that participants in the SOLAR condition experienced significantly lower levels of anxiety and depression, and PTSD symptom severity between pre - and post-intervention (T1 to T2), relative to the Self-Help condition, while controlling for scores at intake. These differences were not statistically different at follow-up. The SOLAR programme was associated with large effect size improvements in posttraumatic stress symptoms over time.Conclusion: The SOLAR programme was effective in improving anxiety, depression and posttraumatic stress symptoms over time. However, by follow-up the size of the effect was similar to an active self-help condition. Given the ongoing stressors in the community associated with compounding disasters it may be that booster sessions would have been useful to sustain programme impact.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12621000283875..
We tested the efficacy of a brief, skills-based psychosocial programme under randomised controlled conditions following compound disasters.The SOLAR programme was associated with improvements in anxiety, depression and posttraumatic stress symptoms across time.The SOLAR programme may benefit from booster sessions especially where there are ongoing impacts of disaster.
摘要:
背景:与气候变化相关的灾害对心理健康的影响是巨大的。然而,获得精神卫生服务的机会通常受到训练有素的临床医生的限制。尽管在政策设置中通常优先考虑建立当地社区的心理健康应对能力,缺乏基于证据的计划是有问题的。这项研究的目的是测试在复合灾害(干旱,野火,与大流行相关的封锁)在澳大利亚。方法:对36名社区成员进行了太阳能项目培训,以技能为基础,创伤知情,心理社会方案。66名焦虑症患者,抑郁症和/或创伤后应激症状,和损害被随机分配到太阳能计划或自助条件。他们被预先评估过,干预后两个月。SOLAR计划分五个每小时一次(面对面或虚拟)进行。那些处于自助状态的人每周都会收到包含自助信息的电子邮件,其中包括在线教育视频的链接。结果:多组分析表明,在太阳能条件的参与者经历了显著较低水平的焦虑和抑郁,干预前后PTSD症状严重程度(T1至T2),相对于自助条件,同时控制摄入量的分数。这些差异在随访中没有统计学差异。随着时间的推移,SOLAR计划与创伤后应激症状的大效应大小改善有关。结论:SOLAR方案能有效改善焦虑,随着时间的推移,抑郁症和创伤后应激症状。然而,通过随访,效果的大小与主动自助状态相似。鉴于社区中与复杂灾害相关的持续压力源,助推器会议可能有助于维持方案影响。试验注册:澳大利亚新西兰临床试验注册标识符:ACTRN12621000283875。.
我们测试了一个简短的功效,复合灾害后随机对照条件下的基于技能的社会心理计划。太阳能计划与焦虑的改善有关,抑郁和创伤后应激症状。太阳能计划可能会受益于助推器会议,特别是在灾难持续影响的情况下。